27 April 2007

Are you HIV positive?

Sometimes conversations can be real downers. Yesterday, I had one of those talks with my friends Natalina and Ventris. They are visiting researchers in political science and history from the U.S.. Natalina has been studying Mozambique's informal markets, and grassroots organization for HIV/SIDA support and education. During the course of her market research she kept meeting HIV positive women trying to support their families. This led to her current exploration of the HIV/SIDA crisis in Mozambique. She interviews HIV positive individuals (mainly women), as well as medical staff at hospitals and clinics throughout the country.

We were talking about marriage and living apart from your spouse for long periods for research. Like Chris and I, she and Ventris were apart for a long period when she first came out to Mozambique. So Natalina has a sympathetic ear when it comes to me talking about missing my husband.

I mentioned to her a conversation that I had last weekend with my husband Chris. I told him that he didn't need to ever worry about me cheating on him in the field because (1) I love him very much, but also (2) the first thing I think when I meet someone new here is, "Are you HIV positive?"

I feel horribly guilty admitting this, even though it in no way affects my interaction with a person. The reason I think about their HIV status is because I wonder how long I will be able to interact with them and enjoy our potential friendship. They could get hit by a truck tomorrow (and so could I, given the driving in Maputo), so really, their HIV status doesn't matter. However, I am sensitive to other people's pain. It saddens me thinking about the illness that they will most likely experience in the future if they are HIV positive (or the pain of losing a loved one to the disease). I don't know if that makes any sense, but there it is.

I felt guilty admitting this, but Natalina and I are good friends. We have had many conversations on a lot of strange topics. I felt a little relieved when she said that she often thinks the same thing. But she says that it is worse for her. Working with HIV positive people makes you hyperaware of HIV/SIDA's symptoms. Natalina says the number of people walking around in Maputo with symptoms of HIV, if you know what to look for, is shocking - much higher than the official rate would indicate.

The official rate given by the CDC for Mozambique is around 16%. The real rates are much higher than the official counts. Many people refuse to be tested, and others refuse to admit that they are sick (particularly men). These selfish individuals continue to have unprotected sex (with both spouses and others), thus spreading the virus even further. Serial killing wife after wife after girlfriend. According to a 2006 UN report, the rates for pregnant women ages 15-45 have increased dramatically since 2000 (countrywide 11% in 2000 to 16% in 2004). In Maputo province, the rates for pregnant women rose to 18-27% in 2004. Most of the official statistics are based on HIV rates in pregnant women, since they seek treatment to prevent their unborn children from being HIV positive.

Unofficially, the rate for Maputo Province is probably around 45% - based on observations by medical personnel. That means that every other person I meet is probably HIV positive. Natalina interviewed a public clinic nurse on Ilha de Mocambique (Nampula Province, up north) who says in 10 years (maximum) that the island will be empty of people. Everyone the nurse has tested has been HIV positive, and she has worked around HIV positive people long enough to know the symptoms and diagnose the effects of the virus in the untested.

Many in the aid community and Mozambicanos believe that people up north have lower rates because they are Muslim. Bullshit. Men sleep around. So do some women, although it seems to be more common among men (but who are those men sleeping with?). It doesn't matter whether they are Muslim, Christian, or practice traditional religions. It doesn't matter how faithful a person is if their spouse sleeps around. In many cases here, a woman cannot ask her husband to use a condom for fear of being beaten - even if she knows that she is HIV positive. Women can be kicked out of the family compound when their husband dies from SIDA related complications - blamed for his death and left with nothing. SIDA orphans wander the capital barefoot, begging for a few metacais to buy bread to eat and picking through the garbage to find food and valuable things to resell.

I remember a long time ago in junior high school when AIDS was a new thing. That was a very long 23 years ago.

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